Demonstration of a non-pneumatic anti-shock garment – also called a lifewrap – to stop post-partum haemorrhaging. Photograph: Akintunde Akinyele/Pathfinder International

Space-age technology, neoprene (the material used for wet suits) and Velcro have gone into an experimental garment that health experts hope can treat postpartum haemorrhage, the leading cause of maternal mortality.

A non-pneumatic anti-shock garment (NASG) – also called a "lifewrap" – is a half-body suit that is strapped on to a woman's lower legs and abdomen to slow bleeding and prevent shock due to blood loss.

"It [the lifewrap] works in two ways: it compresses the blood vessels in the lower part of the body, reversing shock by giving back oxygen to the heart, lungs and brain, which are very oxygen-dependent tissues," said Suellen Miller, director of the Safe Motherhood Programme/Bixby Centre for Global Reproductive Health at the University of California San Francisco (UCSF).

If it works as intended, pressure on the abdomen decreases the radius of the blood vessels and reduces overall bleeding.

According to the World Health Organisation (WHO), postpartum haemorrhage – the loss of 500-1,000ml or more of blood within 24 hours after birth – accounts for nearly a quarter of maternal deaths and is the leading cause of maternal mortality in most low-income countries.

"Maternal death tracks the inequity between countries. Death from postpartum bleeding is nearly unheard of in the developed world," said Kate Gilmore, deputy executive director of the UN Population Fund (UNFPA).

The lifewrap, which evolved from a suit researched and developed by the US National Aeronautics and Space Administration for space programmes, was demonstrated to health experts at a maternal health conference in Kuala Lumpur, Malaysia.

Buying time

The lifewrap is not designed as a final solution to save women, but as a stabilising measure to buy time before transfer to a health facility for surgery or blood transfusion.

In developing countries most women in remote communities give birth at home, according to US-based reproductive research body the Guttmacher Institute. The proportion of births in health facilities varies widely globally, according to the institute, from half of deliveries in eastern and western Africa to 99% in east Asia.

In 2010, the institute recorded 284,000 women in developing countries dying from pregnancy and childbirth complications.

"A woman has maybe two hours [from the onset of bleeding] before she suffers from lack of oxygen to her vital tissues and bleeds to death. Delays are killers," said Miller.

"Working in parts of the world where distance is the difference between life and death demands solutions that can begin in the community or in the home," said Purnima Mane, president and CEO of Pathfinder International, a US non-profit family planning and reproductive health organisation.

Driving down costs

Clinical trials and studies on the lifewrap were conducted by the UCSF in Nigeria, Egypt, Zambia, Zimbabwe and India from 2004 to 2012. During that period, use of the lifewrap decreased maternal death by up to half.

Though cautious not to attribute the drop to these wraps alone, and recognising that multiple interventions may have been responsible for the decline, experts were encouraged by the correlation.

"Initial results from the testing of the garment are promising. We already have the [supporting] WHO policies. Now we want to encourage countries to review their maternal health protocols regarding postpartum haemorrhage and integrate the use of the lifewrap into their designed interventions," said Amie Batson, Path chief strategy officer.

WHO guidelines on the management of postpartum haemorrhage call for timely medical intervention, which includes administering drugs like oxytocin and misoprostol during the third and final stage of labour. These drugs help contract the uterus, expedite delivery of the placenta and reduce blood loss.

In the event these drugs do not work, the WHO published guidelines in 2012 promoting uterine compression, and the use of NASGs specifically, as a temporary measure until appropriate care is available.

The lifewrap can be used up to 40 times and washed by hand with detergent after each use. From an original cost of $300 per garment, negotiations with manufacturers have driven down the cost to about $65.

Community workers are filling the gaps in skilled healthcare in sub-Saharan Africa, but with 500 days until the millennium development goals expire, targets on maternal and reproductive health are far from being met. Liz Ford reports